February 2011

Many North Carolina workers’ compensation news stories involve subtle and arcane discussions about insurance rates, employment policy, and the state’s fiscal strategy. This blog wanted to take some time out to examine two more “down to earth” stories that should hopefully pique your interest and stir up discussion.

1. First on the docket: crazy workers’ comp fraud case.

On February 23rd, the Louisiana Workforce Commission reported an arrest for workers’ comp fraud. The owner of Streamline Framing Incorporated, Richard H. Woodle, allegedly engaged in “willful misrepresentations by an employer and unlawful practices” and was hit with felony charges. A local news outlet reported that the business owner made false reports to his workers’ comp insurer for three years to get out of paying his workers’ comp premiums. By lying to his insurer, “it is estimated that Woodle avoided paying hundreds of thousands of dollars in premiums.” The man could face a decade behind bars for felony workers’ comp fraud.

2. Story No. 2: KFC retaliation.

A KFC worker claims that his employers retaliated against him for filing for workers’ comp.

Most North Carolina workers’ compensation claims (and claims from other states) involve straightforward scenarios. An office worker gets carpel tunnel syndrome and then seeks benefits to pay for her hand surgery, for instance. Or a hurt dockworker struggles with an insurance company to get fair payment for his disability.

An Illinois worker at a KFC has filed suit in Madison County Circuit Court, alleging that his employers fired him for filing a claim. Michael Franklin managed a KFC on Johnson Road for more than 8 years. Last January, he reported an injury to his employer and made a claim pursuant to the Illinois Workers’ Compensation Act. 11 months later, his employer fired him. Franklin wants Morgan Foods to pay him $100,000 for compensatory and punitive damages.

If you or someone you love has been engaged in a fractious dispute with an employer or insurance company over your benefits or another workplace issue, it may behoove you to get a free consultation from a reputable North Carolina workers’ compensation law firm.

Last week, the Workers’ Compensation Research Institute (WCRI) released a study that found that North Carolina workers’ compensation costs were the highest per claim among 16 states. The WCRI report offers sobering news… but can it really be trusted?

Not according to the North Carolina Advocates for Justice (NCAJ). CEO Dick Taylor put out a scathing statement about the WCRI report, calling it “an unfortunate example of insurance companies and corporations seeking government subsidies by shifting their expenses to tax payers… WCRI is funded by insurances and big corporations and routinely issues reports that support “reforms” that would increase their contributors’ profits.”

The NCAJ rebuttal says that the WCRI charge about payment per claims being too high in NC just doesn’t hold water. North Carolina workers’ compensation “doesn’t cover many injuries sustained in normal work routine. North Carolina has fewer claims… and they are far more severe injuries. Naturally, our average payment per claim is higher.”

The NCAJ rebuttal also points out that the North Carolina workers’ compensation system tends to deliver good value per dollar spent… and at a relatively low cost to employers. NCAJ officials worry that corporate and insurance company interests may be tempted to leverage this WCRI study to slice into benefits for hurt workers. Indeed, business advocates are currently lobbying the North Carolina General Assembly to cut off workers’ comp benefits after 500 weeks. Such a proposal may not be popular – even with conservatives. According to an October poll conducted by Public Policy Polling (PPP), the idea of cutting off workers’ comp for hurt workers after 500 weeks is opposed by more than three quarters of liberals and 60% of conservatives.

The fracas over the WCRI report and the NCAJ counterclaims also illustrates a major problem when it comes to formulating public policy. Given enough “torturing” of any data, it can be pretty easy to support your point and/or refute your opponent’s point. For instance, the conclusions you draw may depend on how you look at trends. So it’s incredibly important that policymakers look to multiple perspectives before doing things like enacting major changes to legislation or cutting off benefits to large groups of people.

If someone you care about has been struggling with benefits, a North Carolina workers’ compensation law firm can be a tremendous ally in your battle to get fair payments and hold your employer and that employer’s insurer totally accountable.

Earlier this week, NC Governor Beverly Perdue spoke at length to 100 members of North Carolina’s AFL-CIO about North Carolina worker’s compensation and other critical issues. Gov. Perdue sounded a battle-ready tone as she defended her record of freezing spending, eliminating positions in the state government, stripping benefits programs, and making other Spartan accommodations to jumpstart the state’s economy and attract new businesses to town.

Governor Perdue and the AFL-CIO have been lobbying hard to prevent corporate and insurance interests from enacting legislation that would end North Carolina workers’ compensation benefits for injured workers after 500 weeks. The Governor said: “the AFL-CIO really understands what’s at stake…our future is at stake. Every decision that will take resources away from your child and my child’s public school is a bad decision.”

According to an AP report, North Carolina’s union membership is just 3% – around four times smaller than the national average.

Whether or not business interests enact changes to the North Carolina worker’s compensation system, the governor’s battle with the newly GOP-dominated state legislature seems poised to create political sparks. The Governor seems more than willing to put on her boxing gloves, if her spirited 20 minute speech to the union offers an indication of her fight-readiness.

Benefits issues make for good political theater, but hurt and sick workers care little for these battles over the system. They merely want to get maximum assistance for their injuries/disabilities and get on a path to getting back to work as quickly as possible.

While this blog attempts to discuss mainly “consumer friendly” information about North Carolina workers’ compensation, sometimes we turn our attention to technical – even abstruse and obscure – stories to “kick the tires” on important issues.

In that vein… a very interesting (in a subtle way) news story broke out of Jefferson City Missouri last week. The MO Attorney General, Chris Koster, finalized an arrangement with two companies that had violated MO’s workers’ comp laws. Both Specialty Risk Services, LLC (a Connecticut-based company) and Broadspire Services, Inc. (a Georgia company) were called to task for failing to file reports on behalf of companies that reported injured workers.

According to Missouri law, worker related accidents must be reported to the Missouri Division of Workers’ Compensation within 30 days. Both SRS and Broadspire on many different occasions failed to report injuries by this deadline. The settlement amount was relatively small. Certainly, you can find examples of North Carolina workers’ compensation settlements that don’t make the news that involve much more money. SRS had to pay out $75,000 to Missouri; Broadspire had to pay just $28,500. Also, per the arrangement negotiated by Koster, both companies agreed to having violated Missouri law and agreed to prevent recurrence of violations and stay in compliance for at least two years.

So it’s a small story. And it’s definitely (and, rightly) been buried in the popular press.

But the story hints at something much bigger.

Perhaps a not-insignificant slice of the inefficiencies in the North Carolina workers’ compensation system might be due to the negligence and carelessness of third-party intermediaries. Why is this interesting? Because workers’ comp experts focus nearly exclusively on insurance companies, business owners, employees, and relevant government agencies. They almost certainly don’t bring enough scrutiny to bear on intermediaries like SRS and Broadspire.

This isn’t to say these companies are necessarily bad. Rather, it’s to say that the network of players who impact the NC workers’ comp system may be both broader and deeper than the experts realize. And that means that opportunities for system waste are broader and deeper; and opportunities for powerful corrective actions that can redound to the entire system’s benefit are also possibly more abundant than we realize!

This very technical argument is probably beyond the scope of injured or ill workers who simply want help. If you need assistance to get an employer to pay out benefits, compel an insurance company to treat you fairly, or untangle the red tape that’s wrapped around your claim, get in touch with a responsible, reliable North Carolina workers’ compensation law firm.

This blog (and other media outlets, both in the mainstream and in the blogosphere) recently reported on a heart breaking North Carolina workers’ compensation case involving a middle school principal in Robeson County who was shot point blank in the face while driving to school.

Principal James Hunt miraculously survived the shooting. And he has managed to recover physically, despite having to undergo 9 facial reconstruction surgeries. But his battle to collect North Carolina workers’ compensation benefits from the Robeson School District and the North Carolina Department of Public Instruction is perhaps as frustrating as – or even more frustrating than – the ongoing search to find out who pulled the trigger that fateful morning.

As this blog reported several months ago, Hunt won his case. But now the school system has appealed the verdict. According to a WMBF News report, “in the meantime… [Hunt] is living on just 50% of his old salary and what his wife makes as a school secretary.” WMBF reports that: “Hunt… [believes] that since he was on his way to work and was conducting business on his cell phone at the time he was shot, he deserves payment for all the costs his health insurance isn’t picking up.”

It has been established that Hunt was on his cell phone — on school business — when the shooting occurred. And he was also on his way to work.

Here’s another example: remember our blog’s report from several months ago about the woman who slipped and fell on a parking lot while walking to her office? Her employer fought her workers’ comp benefits, even though she fell just inches away from the door to her workplace! Had she crossed the threshold and then fell, she wouldn’t have had any problem.

What’s especially frustrating in cases like Principal Hunt’s is the revelation that institutions built to support employees can abandon them during the time of their greatest need. Principal Hunt got shot because he took a courageous stand against gangs, according to analysts at the North Carolina Industrial Commission. But after the shooting, instead of trying to do right by the principal, his employer fought his workers’ comp case at every step along the way.

Fortunately, if you or a family member or a close friend got injured or sick at work, you don’t have to battle your employer (or your employer’s insurance company) on your own. Talk to qualified experts at a North Carolina workers compensation law firm to review your best next steps.

Whether you’ve been on North Carolina workers’ compensation for two weeks or eight years, with your doctor’s blessing, you’re now ready to start looking for part-time work again. This blog post will give you ideas about how to make this transition as painless and productive as possible.

If you take certain work while on workers’ comp, you may violate the terms of your benefits. Not only could you lose your benefits as a result, but you could also get in trouble for North Carolina workers’ compensation fraud. Penalties for fraud can include fines as well as jail time, so play it safe.

For instance, say you twisted your knee badly on a construction site. Your orthopedist and physical therapist helped you recover full function of the damaged joint. Now you’re tempted for financial reasons to get back on site and start drilling holes (or whatever) again. Careful! A too-early return to work could undermine the sensitive reconstruction efforts.

Your basic process should be: “Start small. Test. Ramp up a bit. Test. Ramp up a bit more. Test again.” And so forth. Yes, it can be frustrating to have to hold back when you “know” you could handle more. But the goal here is not a one-time push or exertion – it’s the ability to engage productively in the work that you love for as long as you want to do that work. If you shortcut the recovery process, you may make it difficult, if not impossible, to recover fully.

3. Pay attention to medical issues that snag your attention

Often, in our desperation to return to gainful employment after an injury or illness, we ignore or subconsciously repress feelings of pain, uncertainty, and anguish. Especially if your family is depending on you to produce — and your coworkers and employer are counting on you to “step it up” in the wake of your recent time off — you may be tempted to go faster, harder, or more vigorously than your body is ready for. Don’t ignore your body!

One way to identify your subconscious feelings about your work is to keep a journal. Write down your experiences after every work shift. Note any chronic or acute pain or even general odd feelings you have about your job. Often, these written descriptions of your day-to-day work will give you clues to help avoid re-injury and even speed up your recovery. For instance, you might notice that a specific kind of bending exacerbates your pain. If so, talk to your boss about not having to do that bending work anymore.

4. Get advice you can trust

Is your employer giving you a hard time about your benefits? Are you caught up in insurance red tape? Are you confused about something you read on the North Carolina Industrial Commission (NCIC) website? If so, a qualified North Carolina workers’ compensation law firm can give you insight and guidance about how best to proceed.

Few industrious workers dream of spending months or years out on North Carolina workers’ compensation, earning less than they had been earning and struggling to break through the red tape put up by employers and insurance companies. That said, workers often pay surprisingly little attention to easy preventative measures that could drastically reduce their likelihood of going on workers’ comp. Here is a primer on common mistakes and how to avoid them.

1. Fail to Take Breaks

Do you sit for 10 hours a day at a computer and type or do work on the web? Do you work at an industrial facility and engage in repetitive motions? The longer you perform an activity, and the more repetitious that activity is, the more likely you will be to get hurt from that activity. Even mousing on your computer too much can distort your musculoskeletal system, cause inflammation, and force you to compensate in awkward and potentially dangerous ways.

In addition to getting better ergonomic equipment and more variation in your job, make sure to take breaks. Don’t expect to take them automatically. Use a computer program (or app on your phone) to remind you to take breaks every 15 minutes or 30 minutes.

2. Fail to Review Safety Information

Imagine your first day on an assembly line job where you deal with hot liquids, giant pieces of machinery, and huge blades slicing through things. Chances are, you will pay a lot of attention to your supervisor as she walks you through safety tips and procedures. Now cut to eight months later. You come in for a standard, typical day – in the same dangerous setting. Do you think eight months into your job, you will be as respectful of the machinery as you were on Day One? Probably not. The machines are just as dangerous, though!

To prevent getting lulled into a “disrespect” of workplace dangers, set a calendar reminder to review safety procedures and protocols. Make your safety reminders as vivid as you can so they’ll stick in your mind.

3. Give into a “Culture of Danger”

Human beings are notoriously susceptible to social influences. If you work at an office where every employee cleans up, adheres rigorously to safety protocols, and logs all mistakes, chances are that you will take those actions too. On the other hand, if you work in a place where employees slack off and ignore glaring problems, chances are that you will ignore problems too.

There is a way to combat this tendency. First off, if you are a supervisor or owner of a company, be on the alert for “slacking off” and take immediate measures to stop it. If you work at a place where employees disrespect workplace dangers, consciously strive to “break” from this culture of danger and follow safe and proper conduct. It takes a tremendous amount of effort to go against the grain in a workplace culture, so it’s easier to have management work on this for you. But if you can’t make headway, at least start with yourself and see if you can’t recruit a few other likeminded individuals to join you in creating a culture that’s more safety conscious.

To get efficient help with your claim, contact a North Carolina workers’ compensation law firm. Whether your employer is withholding benefits or the responsible insurance company is holding up your benefits in red tape, a good attorney team can make an enormous difference.

An intriguing new study published in the January issue of the magazine Spine has critical implications for North Carolina Workers’ Compensation patients. The study, out of Massachusetts’ General Hospital, looked at nearly 1,000 patients with lower back pain and leg pain stemming from herniated discs and sciatica. Some patients underwent surgery to treat back problems. Other patients received non-surgical interventions such as drugs, physical therapy, and exercise plans. The leader of the study, Dr. Steven Atlas, discovered that, while surgery initially yielded better results for patients; after two years, the differences between the surgery patients and non-surgery patients dwindled away – at least for Workers’ Comp patients.

In other words, injured patients who got surgery for sciatica faired equally as well as injured patients who did non-surgical treatment, two years down the road. The implications for treatment of North Carolina Workers’ Compensation patients seem pretty profound. They suggest that surgery may not be the best course for action for some sciatica patients.

Here is one potential explanation of these results: BOTH surgery and non-surgical interventions may not deal effectively enough with fundamental back health problems. Consider: nodules of fibrous tissue (called trigger points) will form at stressed sites in the muscle tissue. These trigger points have been implicated in causing all sorts of soft tissue injuries and repetitive stress problems, from Carpel Tunnel Syndrome to lower back pain. Neither of the two interventions studied effectively located and resolved the trigger points that might have been causing/exacerbating the sciatica. Thus, it makes sense that the treatments would yield similar (less than stellar) results two years out.

It would be interesting to see how the patients studied would have compared with a third cohort of patients who received trigger point therapy and other soft tissue treatments for their backs.

The big point here is that North Carolina Workers’ Compensation patients must keenly research their treatment options. What is in vogue today, medically, may be disproven tomorrow. Thus, it’s important to speak with your physician at length before making any decisions. Informed patients can work more effectively with their doctors and, theoretically, develop more proactive recovery plans.

Few hardworking individuals prefer to stay on North Carolina workers’ compensation benefits indefinitely. Unfortunately, with the state’s job market still somewhat in limbo – and with your own medical future potentially in doubt, you and your family may be losing hope that you will ever be able to transition back to the workforce in a real and meaningful way. This blog post will hopefully inspire you to realize that return to work is indeed possible – and you may be able to get back on track faster than you ever realized. Here are some things to think about:

1. Are you really getting the “best care” for your condition?

Employees’ who suffer an occupational disease, like chemically-induced emphysema or repetitive work-induced damage to soft tissue, do not always get high quality care from their doctors. Busy physicians may overlook important causes; a more holistic approach to wellness may be needed. For instance, say a person gets a serious typing injury while working at a bank in the Research Triangle. His doctor gives him cortisone shots. These don’t work, so he’s told to undergo surgery. The surgery may offer temporary relief. But the underlying insults to the soft tissues and ligaments and muscles may not be repaired – thus, someone on North Carolina workers’ compensation benefits may remain out of good working condition… until he re-learns how to use his or her body correctly and eliminates fibrous nodules called “trigger points” in the upper back, chest, and thoracic regions.

2. Focus on your goals and eliminate your road blocks

Professionals in athletics and business coaching often emphasize goal-oriented thinking. Rehab specialists also encourage thinking in terms of goals – and using visualization. But many recovering workers are never encouraged to think in vivid positive terms about the future. They are merely told to “get back to normal.” It may be more helpful to aim for a very positive, optimistic outlook to galvanize healing. It’s a lot more exciting, for sure, to think about going back to work and earning twice as much as you had been earning than it is to daydream about maybe, possibly getting your old job back and working half the hours.

3. Focus on improving your strength

When you are on disability, you may be tempted to spend a lot of time resting and recuperating. This is good. But don’t let this sedentary attitude harden. Improving your muscular strength can have many long-term benefits. Talk to your doctor and rehab specialist about doing isometric strength training exercises (ideally, in a slow, controlled fashion) to speed up your recovery time.

4. Avail yourself of good legal resources

A North Carolina workers’ compensation law firm can provide a free evaluation of your current situation and help you think strategically about how to collect benefits, how to budget for the near and mid-term future, and how to get additional resources to improve your recovery.

Last Wednesday, the Montana House of Representatives passed a piece of legislation barring illegal immigrants from being able to collect workers’ comp benefits – the measure has set off a vigorous debate among North Carolina workers’ compensation and illegal immigration analysts.

Here’s what’s going on and why:

The Montana Legislature is gearing up to “fight” illegal immigration and the negative consequence of this immigration. In addition to HB 71, which bars illegals from collecting workers’ comp, Montana lawmakers will likely vote soon on a bill that will require driver’s license applicants to verify their immigration status through a Federal database.

Last Wednesday’s 69 to 31 vote in favor of HB 71 was hailed by supporters, who believe the law will curtail workers’ comp costs and disincentivize employers from hiring illegal immigrants. Opponents, however, argue that hurt workers will now be forced to use hospital emergency services; the costs of their care will be passed down to consumers and insurers. They also argue that businesses which hire illegal immigrants – even accidentally – can now be penalized with serious lawsuits – suits big enough to destroy companies. A Republican from Sydney, Representative Walter McNutt, remarked: “It might only be four cases, but it could put an employer out of business… think hard before you vote for this. You may not be doing the best thing you can for the business people and employers of the state.”

The Court of Appeals in the District of Columbia (DC) recently voted to overturn a similar measure that said employers did not have to provide workers’ comp for illegal immigrants.

If you or a coworker or relative faces difficulties collecting from an employer or an insurance company, get good, reasoned assistance as early as you can in the process. Talk to a North Carolina workers’ compensation law firm about what you can and should do to make the process faster, simpler, and more economical.